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Biomedical subjects

J Lindahl

Publications and source records attributed to J Lindahl.

At least 19 recordsLinked to original sources
PubMed2001

High-dose chemotherapy and APSCT as a potential cure for relapsing hemolysing AILD.

Angioimmunoblastic lymphadenopathy with dysproteinemia (or dysgammaglobulinemia) (AILD) is a lymphoproliferative disorder with cytogenetic and molecular abnormalities characteristic of malignant T-cell lymphoma (angioimmunoblastic T-cell lymphoma -- AITL). We report the clinical course of a 58-year-old male patient with unusually aggressive AILD, including severe hemolysis and Guillain-Barré syndrome, who entered complete remission after CHOP therapy, but had a full relapse after 2 months. At relapse, treatment with high-dose chemotherapy followed by autologous peripheral stem cell transplantation (APSCT) with CD34 selected cells was shown to be successful. The patient is alive and disease-free 3 years after diagnosis and 32 months after APSCT. Considering the poor prognosis of the majority of patients with AILD, intensive treatment followed by APSCT, may be a subject for further studies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1999

Failure of reduction with an external fixator in the management of injuries of the pelvic ring. Long-term evaluation of 110 patients.

We reviewed 110 patients with an unstable fracture of the pelvic ring who had been treated with a trapezoidal external fixator after a mean follow-up of 4.1 years. There were eight open-book (type B1, B3-1) injuries, 62 lateral compression (type B2, B3-2) and 40 rotationally and vertically unstable (type C1-C3) injuries. The rate of complications was high with loss of reduction in 57%, malunion in 58%, nonunion in 5%, infection at the pin site in 24%, loosening of the pins in 2%, injury to the lateral femoral cutaneous nerve in 2%, and pressure sores in 3%. The external fixator failed to give and maintain a proper reduction in six of the eight open-book injuries, in 20 of the 62 lateral compression injuries, and in 38 of the 40 type-C injuries. Poor functional results were usually associated with failure of reduction and an unsatisfactory radiological appearance. In type-C injuries more than 10 mm of residual vertical displacement of the injury to the posterior pelvic ring was significantly related to poor outcome. In 14 patients in this unsatisfactory group poor functional results were also affected by associated nerve injuries. In lateral compression injuries the degree of displacement of fractures of the pubic rami caused by internal rotation of the hemipelvis was an important prognostic factor. External fixation may be useful in the acute phase of resuscitation but it is of limited value in the definitive treatment of an unstable type-C injury and in type-B open-book injuries. It is usually unnecessary in minimally displaced lateral compression injuries.

Activities of Daily Living↗
PubMed1997

Expression of LAZ3/BCL6 in follicular center (FC) B cells of reactive lymph nodes and FC-derived non-Hodgkin lymphomas.

Chromosomal translocation resulting in abnormal expression of the LAZ3/BCL6 gene in B cells has been implicated in the tumorigenesis of non-Hodgkin lymphoma (NHL). Therefore we studied the expression pattern of LAZ3/BCL6 by in situ hybridization with synthetic oligonucleotide probes in frozen tissue sections from five reactive lymph nodes and 38 B cell and non-B NHL. In addition, we investigated the expression of LAZ3/BCL6 by Northern blot analysis on multiple human tissues. The LAZ3/BCL6 transcript was found in a variety of tissues, including skeletal muscle, peripheral blood leukocytes, and weakly in normal lymph nodes. In the tumor samples, expression of LAZ3/BCL6 was observed in 68% of all B cell NHL and none of the non-B lymphomas. All cases of follicular, mixed small and large cell lymphomas showed LAZ3/BCL6 expression confined to the neoplastic follicles. A follicular expression pattern was also found in all non-malignant reactive lymph nodes. Hence, the expression of LAZ3/BCL6 does not correlate to malignancy, but reflects the origin of B cells from the germinal centers.

B-Lymphocytes↗
PubMed1993

A new approach to the internal fixation of unstable pelvic fractures.

Eighteen patients with horizontally or vertically unstable pelvic fractures were operated on with a new intrapelvic technique. There were 11 horizontally unstable and seven vertically unstable pelvic ring fractures. The fractures were exposed through a low Pfannenstiel or lower midline incision combined with an incision at the iliac crest. This is referred to as the ilioanterior approach. At the operation, all lesions in the symphysis, rami, and in the sacroiliac region were reduced and fixed with reconstruction plates and screws. No intraoperative complications ensued. The average intraoperative blood loss was 930 ml and the operation time averaged two and one-half hours. The obtained reduction was maintained in all but one sacral fracture. All fractures united. The functional recovery was uneventful in all the patients. The good results obtained in this relatively small series encourage further development of operative techniques in unstable pelvic fractures.

Adolescent↗
PubMed1993

Bacterial contamination and closed suction drainage in open meniscectomy of the knee.

A prospective study was undertaken to investigate the occurrence and possible sources of microbial contamination in association with open meniscectomy of the knee. Sixty patients were randomized into three closed suction drainage regimens of 12, 24 and 48 hours' postoperative suction drainage, respectively. Specimens for bacterial culture were taken from the joint at the time of surgery, from the surgical suction tips, from the subcutaneous part of the drain surface and from the drain-contained fluid at the time of drain removal. The airborne bacterial contamination showed no marked role in this bacterial invasion into the joint, nor did the use of suction increase the risk. The vacuum suction drain, on the other hand, appeared to carry an obvious risk of bacterial invasion, as a parallel of time. In the present comparison this risk was minimal when the drain was removed 12 hours postoperatively.

Acinetobacter Infections↗
PubMed1989

99m-technetium-HmPAO-labelled leucocytes in the diagnosis of acute colonic diverticulitis.

Eighteen patients with abdominal symptoms clinically resembling acute colonic diverticulitis were studied with 99mTc-labelled leucocytes on average 5 days after the onset of symptoms. The diagnosis of diverticular disease was confirmed in all cases by means of barium enema or sigmoidoscopy. The leucocyte scan was positive in 13 patients, nonspecific in four and unclear in one patient. The diagnostic possibilities in acute colonic diverticulitis are discussed.

Acute Disease↗
PubMed1986

Incidence of heart disease and functional significance of changes in the electrocardiogram 10 years after radiotherapy for breast cancer.

Late cardiac complications after radiotherapy for breast cancer was studied in 197 patients examined before, 6 months after, and 10 years after treatment. The 10-year follow-up was done by survey of the files of patients who had died and re-examination of patients who were alive and free of cancer. Among 95 patients who died, 3 died of cardiopulmonary diseases. Autopsy in 32 patients showed serious cardiac abnormalities in 3. Of 102 patients alive at follow-up, 3 reported heart symptoms. Sixty-nine patients participated in the re-examination. Electrocardiogram (ECG) abnormalities were found in 19% of these patients before treatment; in 45% at 6 months, essentially due to T-wave changes in patients who had received left-sided irradiation; and in 45% at 10 years, with fewer T-wave abnormalities but more ST depression and ectopic beats. Average working capacity was 83 W before, 81 W at 6 months, and 84 W at ten years. Average heart volume was 680 ml before, 689 ml at 6 months, and 718 ml (P less than 0.01) 10 years after treatment. In conclusion, there was a high incidence of ECG T-wave changes, but they were reversible, and the perimyocardial damage indicated was functionally insignificant. The incidence of serious cardiac complications was low.

Autopsy↗
PubMed1984

Effect of ovulation on haem metabolism in rabbits.

To investigate the origin of the cyclic changes in the rate of endogenous carbon-monoxide production (nCO) during the menstrual cycle, haem turnover was determined before and after chorion gonadotropic hormone-induced ovulation in six female rabbits. 14C-labelled delta-aminolevulinic acid and glycine were administered and the excretion rate of 14CO (A14CO) was measured for determination of hepatic and bone-marrow haem turnover, respectively. Carbon-monoxide production (nCO) was measured to estimate total haem turnover. After ovulation A14CO was increased significantly the first 2 h of the early labelled peak after 14C-ALA administration and was increased also at the first determination during the early peak after 14C-glycine but statistically not significantly. The total excretion of labelled CO during the period of the early labelled peak was not increased with any of these precursors for haem synthesis. On the other hand nCO was increased 34% (P less than 0.05) during the post-ovulation period. As the increase in 'unassigned' haem turnover was small and may be unaccompanied by a contemporary increase in bilirubin/CO production, it was concluded that the increase in nCO during the post-ovulation period essentially depends on increased destruction of circulating red cells in the rabbit.

Aminolevulinic Acid↗
PubMed1983

Electrocardiographic changes after radiation therapy for carcinoma of the breast. Incidence and functional significance.

Cardiovascular complications from irradiation for breast carcinoma were assessed by history, physical examination, ECG recording, exercise test and heart volume determination before and two and six months after treatment in 197 unselected patients. A deterioration in general condition during therapy was reported by about 50 per cent of the patients, with shortness of breath and palpitation of the heart as the most frequent complaints and with a gradual improvement after therapy. Clinically, one case of pericarditis was diagnosed. ECG T-wave abnormalities appeared in 35 per cent of the patients after treatment, essentially confined to patients with left-sided pre- or postoperative treatment, where the mean radiation dose to the anterior quarter of the heart usually exceeded 20 Gy. Physical working capacity two and six months after therapy did not seem to be influenced by irradiation alone, and no correlation existed between change in physical working capacity and appearance of ECG T-wave abnormalities. The heart volume increased by more than 200 ml in 2 patients but otherwise the changes in heart volume were small. A high incidence of ECG T-wave abnormalities following left-sided irradiation for breast carcinoma was noted, but in the short term these ECG changes were functionally insignificant.

Adult↗
PubMed1983

Manometric studies of lower esophageal sphincter in extreme obesity.

Esophageal manometry was performed in a group of extremely obese subjects in order to investigate the lower esophageal sphincter (LES) pressure and its relationship to extreme obesity, weight reduction and altered anatomy of the stomach. Forty subjects were examined before gastric surgery for treatment of their obesity, and 14 of these were reexamined after weight reduction. Normal LES pressure (20 mmHg) was found before operation, and also normal length and position of the LES. No significant changes were found in the group which was examined twice. In persons younger than 50, LES manometric findings do not seem to be influenced by extreme obesity, weight reduction or gastric surgery for obesity.

Body Weight↗
PubMed1980

The contributions of erythropoietic and nonerythropoietic haem turnover to the early labelle peak of endogenous CO formation in man.

The endogenous production of 14CO during the first week after administration of glycine-2-14C (early labelled peak, ELP) was determined in 13 healthy subjects. The subjects were studied during normal, suppressed or stimulated erythropoiesis induced by hypertransfusion and phlebotomy, respectively. The production of 14CO was calculated from determinations of the specific activity of the body CO store and the endogenous production of CO. The incorporation of labelled glycine into circulating red cell haemo;globin haem was calculated from the maximal specific activity of haemoglobin haem and the total amount of Hb. The average ELP was 73.0 X 10(3) disintegrations per min (dpm) and the incorportion of glycine into circulating haemoglobin haem 491 X 10(3) dpm in controls. The ELP and the incorporation of glycine increased by 86% and 92%, respectively, in phlebotomized subjects and decreased by 37% and 62%, respectively, in hypertransfused subjects. A linear regression equation was calculated for the relationship between ELP and erythropoiesis, expressed as the incorportion of glycine into circulating haemoglobin haem. The residual ELP remaining in the absence of erythropoiesis was 24.9 X 10(3) dpm calculated from data of all the subjects, and 32.8 X 10(3) dpm calculated from data of controls and hypertransfused subjects only. In conclusion, erythropoietic haem turnover was found to contribute about 60% and nonerythropoietic (mainly hepatic) haem turnover about 40% of the ELP in man.

Adult↗
PubMed1980

Quantification of ineffective erythropoiesis in megaloblastic anaemia by determination of endogenous production of 14CO after administration of glycine-2-14C.

The determination of the early peak of 14CO production that results from haem turnover after administration of glycine-2-14C was studied in patients with pernicious anaemia. The accuracy of this technique in measuring ineffective erythropoiesis was assessed by comparison with other measurements of the severity of the disease. 6 patients were studied before specific treatment and 2 of these also after treatment. The endogenous production of 14 CO was calculated from determinations of the production of CO by a rebreathing technique and of the specific activity of CO washed out from the body CO store by oxygen breathing. The early labelled peak was increased 7-39 times compared to that in healthy control subjects and represented 35-86% of the total production of 14CO as compared to 13% in controls. The early labelled peak was significantly correlated to the Hb concentration, mean red cell volume and endogenous production of CO. 2 patients, twice examined, showed a moderately increased early labelled peak also after specific treatment. This was attributed to persistence of some ineffective erythropoiesis in 1 patient and possibly increased hepatic haem turnover in the other. The magnitude of the early labelled peak and the maximal activity of 14CO found in the samples of CO collected from the body CO store were significantly correlated. In conclusion, with the present method the early peak of 14CO reflected the ineffective erythropoiesis in patients with pernicious anaemia. The early labelled peak could be predicted from the maximal activity of 14CO found in the samples of CO washed out from the body CO store.

Aged↗
PubMed1980

Endogenous carbon monoxide production after bicycle exercise in healthy subjects and in patients with hereditary spherocytosis.

The occurrence of haemolysis after bicycle exercise was studied by determination of, inter alia, the endogenous carbon monoxide production (VCO) before and after 20 min of exercise at a load of about 70% of predicted maximal oxygen uptake. Eight healthy subjects and six patients with hereditary spherocytosis were studied. VCO was 14.4 and 10.5 mumol CO x mmol per total body haeme per day before and after exercise, respectively, in healthy subjects, and 32.6 and 25.4 mumol CO x mmol per total body haeme per day in the patients. The differences were not statistically signficant. No significant changes occurred in serum total bilirubin, lactate dehydrogenase, haptoglobin or serum iron/total iron binding capacity. In conclusion, no increase in the destruction rate of red cells was observed after this type of exercise, neither in healthy subjects nor in patients with hereditary spherocytosis. In addition, a decrease in COHb of about 20% during exercise was observed in both groups. This could be explained by a redistribution of CO from haemoglobin to myoglobin in association with changes in intracellular oxygen tension in working muscles.

Adult↗
PubMed1980

The production of 14CO following the administration of 2-[14C] glycine in normal subjects determined by an oxygen washout technique.

The endogenous production of 14CO during the first week after administration of 2-[14C]glycine, i.e. the early peak of 14CO derived mainly from erythropoietic and hepatic haem turnover, was measured in six normal subjects. Samples from the body CO store were collected by washout of CO with oxygen breathing, CO concentration of expired gas was determined with an infrared CO-meter and, for determination of 14C activity, CO washed out was oxidized to CO2 in a trapping system and absorbed in ethanolamine. The endogenous production of CO was measured with a rebreathing technique and the production of 14CO was calculated. The specific activity and total amount of circulating red cell haemoglobin haem was determined to calculate the potential late peak of 14CO production. The method for determination of 14CO expired was demonstrated to be specific and reproducible and no haemolysis induced by the sampling procedure was detected. The average production of 14CO was 6.94 nCi/24 h the day after injection of 100 muCi of labelled glycine and decreased gradually to 1.08 nCi/24 h on day 8. The early labelled peak was 32.9 +/0 8.1 nCi (mean +/- SD) and the potential late labelled peak 221 +/- 30 nCi. The early peak represented 13.0 +/- 2.9% of the calculated total production of labelled CO, a figure significantly lower than erythropoietic and hepatic haem turnover calculated from total bilirubin or CO production and red cell life span, probably due to the hepatic component being underestimated by the radiolabelled precursor method.

Carbon Monoxide↗